June 12, 2013
As you may have read recently, DoHA have just announced more Aged Care Funding Instrument (ACFI) changes commencing from 1 July 2013.
The changes will be made through amendments to the ACFI User Guide and ACFI Answer Appraisal Pack. These changes are designed to reinforce the original intent of the ACFI and further enhance the evidence requirements.
The changes have been developed in consultation with sector representatives through the ACFI Monitoring Group and its sub-group the ACFI Technical Reference Group.
What are the changes?
1. Behaviour Domain – Questions 7 (Wandering), 8 (Verbal Behaviour) and 9 (Physical Behaviour):
The ACFI User Guide and ACFI Answer Appraisal Pack will be updated to reflect an increase in the frequency of problem behaviours required to support a claim of a B or above.
In questions 7 (Wandering), 8 (Verbal behaviour) and 9 (Physical behaviour) where there is a claim of a B rating or higher, the wording in the ACFI User Guide will be changed from behaviour “occurs at least once per week” to “occurs on at least two days per week”. The claims are required to be supported by the behaviour record and accurately reflect the behavioural needs of the resident.
2. Complex Health Care Domain – Pain Management
Changes in the wording will be made to questions 12.3, 12.4a and 12.4b in the ACFI User Guide and ACFI Answer Appraisal pack to include the requirement of an evidence-based pain assessment to support the claims made.
Specific assessment tools will not be mandated. The Department will provide access to recommended evidence based assessment tools through the ACFI webpage at (www.health.gov.au/acfi). . These include: the Modified Resident Verbal Brief Pain Inventory (M-RVBPI); the Abbey Pain Scale; and the Pain Assessment in Advanced Dementia Scale (PAINAD) as contained in the Australian Pain Society’s Pain in Residential Care Facilities: Management Strategies: The Pain Management Guide (PMG) Kit for Aged Care.
3. Changes to the ACFI User Guide and ACFI Answer Appraisal pack to prevent incongruent claiming in ACFI 2 (Mobility) and ACFI 7 (Wandering).
Generally, a claim of D in ACFI 2 (Mobility) would not be accompanied by a D in ACFI 7 (Wandering). When a high care requirement (D) in ACFI 2 (Mobility) and a high care requirement (D) in ACFI 7 (Wandering) are claimed simultaneously, the service provider must retain evidence to support the claims.
The ACFI User Guide and Answer Appraisal pack will include additional wording with the intention of reminding providers of the evidence requirements for a claim of this type.
When will the changes be implemented?
The changes will apply to any appraisal completed on or after 1 July 2013. An updated ACFI User Guide and ACFI Answer Appraisal Pack are available on the ACFI webpage at (www.health.gov.au/acfi).
What do approved providers have to do?
From 1 July 2013, when you complete an ACFI appraisal, you will need to refer to the new ACFI User Guide and complete the new ACFI Answer Appraisal Pack.
While approved providers will be required to comply with the new arrangements from 1 July 2013, complying with these requirements is not inconsistent with current arrangements and approved providers may wish to ensure their processes meet these requirements prior to the implementation date.